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Press Release

New emergency pathway looking to improve survival rates for one of the most deadly cancers
Press release date09/10/2017
Thirteen patients have now been treated at Leicester’s Hospitals since the launch of a new emergency Pancreatic Cancer pathway in April 2017 which reduces the waiting time from referral to surgery from 6 weeks down to 2 weeks. This has the benefit of reducing weight loss prior to surgery, improving the patient journey and may increase the proportion of patients who will benefit from curative surgery.
Press release

Currently, across the majority of the country, patients present to their GP with symptoms such as jaundice that can potentially be a sign of pancreatic cancer. Their treatment pathway can see them wait 6 weeks from their initial scan (to determine whether they have pancreatic cancer) to their planned surgery. Such is the nature of this deadly cancer that of every 100 pancreatic cancer patients that make it to theatre only 60-65% of patients are operable. In addition patients who present with jaundice may require additional procedures to treat this whilst waiting for their planned surgery. Finally, weight loss is a common symptom with pancreatic cancer and sometimes this may result in patients becoming too weak to have a major operation which typically lasts over 6 hours.  

The pancreatic cancer team at Leicester’s Hospitals, based at the General Hospital, have looked into the research behind speeding up this process and the potential improved outcomes for patients. The research focuses on studies in Sweden which have shown that pancreatic cancer patients’ five-year survival rates improve dramatically if those patients suitable for immediate surgery are operated within two weeks from diagnosis. The survival rates jump from 5% to 30-40% and therefore the Leicester team have developed a new pathway to offer our patients the best chance of survival. The team’s resection rate has also improved with the speeded up pathway for patients increasing to 75%. 

 Deep Malde, Consultant General, Hepatobiliary and Pancreatic Surgeon at Leicester’s Hospitals, said: “This initiative has required close co-operation between myself, Mr Garcea and Mr Bhardwaj (also pancreatic surgeons at the LGH) with support from the radiology, anaesthetic and nursing staff. In order to date these patients within 2 weeks of their diagnosis, we often have to utilise weekend operating lists as it would be unfair to cancel other patients’ planned cancer surgery. There are certainly some patients who are not suitable for this new pathway but by operating on patients as soon as possible from their diagnosis, we are helping to avoid additional unnecessary procedures and other problems such as weight loss. Patients with pancreatic cancer often present as an emergency and we feel that their surgery should be undertaken on a similarly urgent basis. We are hoping to increase our resection rates to up to 80 to 90%.” 

The team at Leicester includes a scrub team, anaesthetists, surgeons and pathologists. They receive tertiary referrals from hospitals across the South East Midlands including taking patients from Kettering, Peterborough, Northampton and South Lincoln. The surgeons visit hospitals across these areas in multidisciplinary team meetings where they can review whether patients are well enough or fit enough for surgery and can be placed on the emergency pathway. 

Two patients who have benefitted from the new emergency pathway are Elaine and Lesley.

Elaine Rawlinson, from Northamptonshire, developed a pain in her abdomen and symptoms of jaundice last December. She saw her GP, Dr Hartley, who referred her on the 'fast -track' programme to a consultant at Northampton General Hospital and for an MRI and CAT scan. Elaine is extremely grateful: “It is down to Dr Hartley's diligence and insight that I was able to be referred in time to enable the treatment I eventually received.”

Elaine was concerned but not too afraid by the potential diagnosis of cancer, adding: “My job as a Humanist Funeral Celebrant brings me into contact with death all the time and because of it I have had to think about mortality and talked to many people and their families who have faced diagnoses with terminal illness.”

She was told that there definitely was a mass in the head of the pancreas and that her case was now being referred to the multi-disciplinary team involving Leicester General Hospital. On 13 June she had the CAT scan and received a phone call from Mr Malde's admin team to come and see him at Leicester General on Friday 16 June.

Elaine highlights how the Leicester team have helped her: “From the minute I arrived at Leicester General for my appointment my whole experience changed.  I was met by Jo, a specialist nurse, who explained she was part of the team that worked with Mr Malde who looked after and treated me with great kindness and understanding.

“Mr. Malde explained the situation and that I had a tumour that needed removing. He was direct and explained things thoroughly, and gave me all the information I needed to make a decision about the surgery - the benefits and the dangers. From the moment I met him and Jo I had such confidence in them and the team at Leicester that I never hesitated for a moment about the surgery.

“I was given a whole range of leaflets that were wonderful in explaining every detail of the procedure and my care and told about the app that had been developed that showed what would be done. I was given contact telephone numbers and encouraged to ask questions and made to feel I was being treated as an individual.

“The speed and efficiency that appointments were made for tests and consultations was amazing - I would receive a phone call and a letter would follow up with a day or two.

“I had my surgery on 29 June and it was a successful removal of the tumour and Whipple's procedure. I was in theatre for seven and a half hours and everyone I came into contact with during and after my operation were wonderful. The anaesthetists, recovery team, physiotherapists, dietician and the nursing and auxiliary staff on the wards were so supportive, professional and treated myself and my family/friends with kindness and understanding.”

The day after her operation she was sitting out in a chair and within two days was walking up and down the ward and eating again within 3 days. She went home a week later and her recovery has been amazing. Six weeks later she is driving, walking the dog, and back working again.

Lesley Burgess also had a similar experience. In July she noticed her skin becoming jaundiced, she lost weight and the colour of her discharge changed. Her GP also knew about the fast-tracking pathway to get her a scan. She was referred to the Leicester’s Hospitals multi-disciplinary team. 

She explains further: “Dr Malde was very good; he was thorough and didn’t rush me. My family were also especially good and they are all pleased to have me back home now. They were all scared as was I. It is all about getting back to normality now. That makes you feel a lot better. What I would say is - that if you notice anything out of the ordinary to tell your GP immediately.”

A new cancer information app called ‘My Pancreas’ was launched on 1 September 2016 by the Leicester General Hospital Hepato-Pancreato-Biliary (HPB) Unit & Design Agency AGF Studio and is available for the public on Apple’s app store for iPhone and iPad. To read more please visit: http://www.leicestershospitals.nhs.uk/aboutus/our-news/press-release-centre/?entryid8=44115  


For more information please visit: http://www.hpbleicester.com/

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